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In Doom 3, Betruger is the director of all research at the Union Aerospace Corporation research facility on Mars. In Doom 3: Resurrection of Evil, he returns as part of a flying gargoyle-like demon named the Maledict and is leading the forces of Hell. He is an elderly, overworked doctor, whose right eye is grayed over with blindness.

In Doom 3, it is stated in an audio log that at some time before the events depicted in the game took place, Betruger inexplicably entered a teleporter, transporting him to Hell. When Betruger returned, he still looked the same, but he behaved differently. This suggests that Betruger may have been possessed or corrupted by a demonic force, though it is never clearly stated exactly what happened to him. What is clear is that he had made a pact with the demons of Hell in which he agreed to provide a portal that the demons could use to invade the facility, in return for great supernatural power, including a degree of omnipresence and the ability to command armies of demons.

Shortly before the invasion, Dr. Betruger acquired the Soul Cube. Knowing that it was the only thing that could stop his plans, he hid it in Hell where no one could find it and use it against him.

Betruger is first seen at the beginning of the game, inside of the Mars Facility Control Tower. He observes a shuttle arrive, carrying Counselor Elliot Swann, Jack Campbell, and a replacement Marine (the player). Later, the Marine eavesdrops on an argument between Betruger and Swann, the latter of whom has been sent by the UAC Board to investigate the disturbing activity surrounding Betruger's experiments. Betruger warns Swann to stay out of his way and cryptically adds that "amazing things will happen here soon." A short while after the demonic invasion, the Marine overhears yet another argument between Betruger and Swann. Betruger appears to be unperturbed by the disaster unfolding around him, and smugly tells Swann that he'll "handle" the situation. Later in the game, Betruger contacts the Marine directly and makes it clear that he is in league with the demons and is plotting to lure the Earth Fleet to Mars. Once they have seized control of the Fleet's ships, they will launch an invasion of Earth itself. A cutscene later reveals that he has gained supernatural powers which enable him to transform other marines into Zombie Commandos. He makes two separate attempts to kill the Marine, first by flooding the area with toxic gasses, and later by opening a portal that pulls the Marine into Hell itself. Both these attempts fail.

Throughout the game, Betruger continues to taunt the Marine and sets his demonic minions upon the player. He typically threatens the Marine with death and the promise that his soul will burn in Hell. Ultimately, however, Betruger's plans are foiled when the Marine recovers the Soul Cube, returns to Mars, and uses the Cube to destroy the Cyberdemon and seal the Hell hole that has been opened below the planet's surface. Five days later, a team of marines and sentry bots arrive at the facility. They rescue the Marine, but are unable to find Betruger. The last scene shows Betruger in Hell, where he has become part of a horrific skeletal dragon-like creature later revealed to be the Maledict.

It should be noted that while in Hell, the Marine is taunted by an unseen presence - one that sounds different than Betruger's normal voice. It is unknown as to whether or not this is still Betruger or an entirely different entity. It most likely is, as the sound files in the paks have the taunts suffixed with bet_, most likely short for Betruger.

The Lost Mission - which takes place during the events of Doom 3 - reveals that Betruger had in fact been contacted by the demons in his dreams. They offered him unlimited power in exchange for retaking Earth, and he accepted their offer. Betruger attempted to have a long ranged teleporter constructed in Hell itself through the newly established Exis Labs. In theory, this teleporter could be used to transport the demons directly to Earth itself. However, since Exis Labs' work on the Hell teleporter was too slow, Betruger decided instead to launch an invasion of Mars through the Delta Labs teleporter and lure Earth's fleet into a trap. The unfinished teleporter in Hell however remained intact and it fell upon a second unnamed Marine (the Lost Mission player) to go to Hell through the Exis teleporter and shut down the device permanently. Though Betruger is not featured prominently in this expansion in person, his echoing laugh is still occasionally heard taunting the Marine as demons are summoned to try to stop him.

At the end of Doom 3, Betruger is shown in Hell as the Maledict, a giant skeletal dragon-like demon which has Betruger's human head on the end of a tongue-like structure inside its skull. It is initially unclear whether this transformation was some form of punishment or what Betruger actually desired, but in the Doom 3 expansion pack Resurrection of Evil, it is made clear. In this form, Betruger lords over Hell and commands his demon "children" to rise up and awaken when he detects that a new portal has been opened to Mars via the Artifact. He commands the three Hell Hunters in particular to hunt down the Marine holding the Artifact. The combat engineer Marine and Elizabeth McNeil must work together to determine how to stop Betruger's final attempt to reach out from beyond the grave.

The Maledict serves as the final boss of the expansion and is found in the uttermost depths of Hell. Despite a valiant battle, he proves too much for the Marine, dodging a final rocket shot and, seeming apparently unfazed by any of the damage dealt during the battle, seizes the Marine in his jaws and thrashes him through the air before slamming him to the ground. He demands that the Marine "return what is ours," referring to the Artifact. The angry Marine complies, but not as Betruger expected - he shoves the Artifact down Betruger's throat, which destroys both the Maledict and the Artifact in a brilliant display of blue light.

At the end, Betruger's steaming human skull can be seen rolling across the ground, presumably the ultimate end for the evil doctor.

Betruger's name comes from the German word "Betrüger" which means "deceiver" or "fraudster".

Dr. Reinhard from Evil Dead: Regeneration has several similarities to Betruger. In addition to looking similar (with a solid white eye), both were said to have been good before their pacts with the undead. They also have German names.

If on the first level, if you use cheat codes to enter the room where Betruger is, he will be identified as "Joe" - the name for all NPCs the player is not supposed to be able to interact with. He has no lines and will not speak with you.

According to the Making of Doom III book, many of Betruger's lines and actions were to be performed by General Hayden, the commander of the military on Mars. Hayden was meant to be the assumed villain, and only later on in the game would it be revealed that Betruger was the true mastermind behind the invasion. Later, the developers decided to remove Hayden's character entirely, and establish Betruger as the villain early on in the game.